A recent Time magazine featured a slightly overweight figure holding two plates of food out to the camera. The plate on her right contained pasta, a sprig of parsley, no sauce, and a few slices of red and yellow pepper. The plate on her right contained what appears to be a 16 ounce porterhouse steak. Above the plates of food the title slug read: "What REALLY makes you fat?" while underneath the picture the subtitle promised "the latest science on how your body handles carbs and fats."

Unfortunately, like the steak, the Time article was all sizzle and about as unsatisfying as the plate of pasta without the sauce. Far from getting 'the latest science' on what makes us fat, we are again treated to the Atkins versus Ornish, both of whom are beginning to have that comfortable feel about dissing each other that reminds me of the golden days of Siskle and Ebert.

In his 'case for low fat,' Dean Ornish, sounding more like a politician with every swing of the pendulum, now agrees with the high protein advocates that 'is it wise to eat fewer simple sugars, such as sugar, white flour and white rice.' However, anyone remembering Ornish's earlier books will nowhere encounter this sort of caveat. His approach was and is fat-phobic, and the high carbohydrate approach advocated by him and other health writers such as the NY Times Jane Brody drew no real distinction between simple and complex carbohydrates (as did the original USDA Food Pyramid.) Ornish (and increasingly the American Dietetic Association) now pay credence to the insulin resistance consequences of high carbohydrate diets.

However, Atkins has only embraced the insulin resistance stance within the last few years - largely as a patch to his earlier, fundamentally unsupported, 'ketosis theory' (the notion that switching to burning ketones instead of sugars caused rapid weight loss.) The success of other books embracing high protein diets, such as The Zone also brought insulin resistance to the fore and Atkins was quick to incorporate the concept.

Readers of my books will note that many carbohydrate food sources are also high lectin containing foods. Many dietary lectins interfere with insulin metabolism, and approximately 60% of dietary lectins have some ABO blood type specificity. Thus it is not simply a matter of 'carbs versus fats' as the media so likes to portray as the issue, but rather that certain foods interfere with insulin metabolism in certain people, and that genetics, including the genetics of the ABO blood groups, can be used to predict this. ABO types also differ by virtue of digestive enzymes which can influence their ability to thrive on either a low-fat or low-carb diet.

What I found interesting about the article (other than the fact that the Atkins Diet seems to have passed the 'hundredth monkey' phenomenon) was the complete lack of interest on the part of the Time editors in any of the genetic aspects of weight gain and loss. They also seemed to have an inability to comprehend the basic fact that both the low-fat and low-carb approaches have value and it will be extremely unlikely that one theory will completely disprove the other. Unless we use an approach that recognizes the genetic components, such as blood type, that can allow this type of scientific duality to exist, I'm afraid that we will not soon see the end these sorts of nutrition controversies.

Like the steak the sizzle can be expected to sell many magazines, and like the pasta there will be enough unfulfilled readers to guarantee a 're-evaluation’ every 5-6 months or so.

This entry was posted on March 18th, 2006 at 12:31:00 pm and is filed under Questions 2000-2006.